Epilepsy is a disorder of brain electrical activity, which presents with symptoms of recurrent unprovoked seizures. For most children with epilepsy, these symptoms or seizures can usually be managed with the first medication prescribed. However, about one-third of patients with epielpsy will continue to have seizures despite trials of more than two medications. These children have medically refractory (or drug resistant) epilepsy, and can be seen in the McMaster Comprehensive Pediatric Epilepsy Clinic.
"Drug resistant epilepsy places a significant burden on patients' quality of life," says Dr. Kevin Jones, Assistant Professor in the Department of Pediatrics, and Pediatric Neurologist and Epileptologist at McMaster Children's Hospital. "Constant seizures can effect development and cognitive ability, and uncontrolled epilepsy can often get worse over time."
Jones was recruited to McMaster to support the epilepsy clinic, working with Dr. Rajesh RamachandranNair and a multidiscplinary team consisting of a nurse practitioner, a social worker, a registered dietician, a neuropsychologist, a psychometrist, and EEG technologists to determine a comprehensive treatment plan for each patient. The team also identifies patients with drug resistant epilepsy who may be candidates for epilepsy surgery, and refers them to a regional epilepsy centre for further treatment.
"The goal of the clinic is to reduce the burden of seizures and improve the quality of life for our patients," says Jones. "For some patients a surgical operation to remove or disconnect the part of the brain causing the seizures may be an option. This can be a very effective solution and may make patients seizure free."(Picture above: Dr. Kevin Jones with his patient, Morgan)
When brain surgery is not an option, a vagal nerve simulator or dietary therapies may be considered, and these too may lead to seizure reduction and improved quality of life.
Through the clinic, Jones also cares for patients with infantile spasms, a type of epilepsy that affects young children ages three months to two years. "It's important to treat these symptoms early," Jones says. "Without proper treatment, patients can experience other seizure types as they get older, and they could have difficulty learning."